The Prussian military thinker Carl von Clausewitz is widely considered the most important of the major strategic theorists. In 1812, building on the works of others, e.g., Sun Tzu and Jomini, he penned the Principles of War. He later expanded these into the classic tome On War. All members and future members of our profession, those who practice and teach the science, philosophy and art of chiropractic, would do well to consider these principles and step up to focus on our commonality, so we can dictate our profession's destiny.
As a young Marine officer going through The Basic School in Quantico, Va., I was introduced to these principles and admonished to the dire consequences of engaging in any combat, with bullets or debate, without fully applying these principles. Clausewitz's nine principles must be followed in order to win in battle, from the lowest level to the strategic level.
MOOSEMUSS
Marines use acronyms and pneumonic phrases (recall the cranial nerves?) to assist our recollection. The acronym for the Principles of War is MOOSEMUSS:1 Mass, Offensive, Objective, Security, Economy of Force, Maneuver, Unity of Effort, Simplicity, Surprise. In the U.S. Armed Forces, they are defined as follows:
Mass – The effects of overwhelming combat power at the decisive place and time. Synchronizing all the elements of combat power where they will have decisive effect on an enemy force in a short period of time is to achieve mass. Massing effects, rather than concentrating forces, can enable numerically inferior forces to achieve decisive results, while limiting exposure to enemy fire.
Offensive – Seize, retain and exploit the initiative. Offensive action is the most effective and decisive way to attain a clearly defined common objective. Offensive operations are the means by which a military force seizes and holds the initiative while maintaining freedom of action and achieving decisive results. This is fundamentally true across all levels of war.
Objective – Direct every military operation toward a clearly defined, decisive and attainable objective. The ultimate military purpose of war is the destruction of the enemy's ability to fight and will to fight.
Security – Never permit the enemy to acquire unexpected advantage. Security enhances freedom of action by reducing vulnerability to hostile acts, influence or surprise. Security results from the measures taken by a commander to protect their forces. Knowledge and understanding of enemy strategy, tactics, doctrine and staff planning improve the detailed planning of adequate security measures.
Economy of Force – Employ all combat power available in the most effective way possible; allocate minimum essential combat power to secondary efforts. Economy of force is the judicious employment and distribution of forces. No part of the force should ever be left without purpose. The allocation of available combat power to such tasks as limited attacks, defense, delays, deception, or even retrograde operations is measured in order to achieve mass elsewhere at the decisive point and time on the battlefield.
Maneuver – Place the enemy in a position of disadvantage through the flexible application of combat power. Maneuver is the movement of forces in relation to the enemy to gain positional advantage. Effective maneuver keeps the enemy off balance and protects the force. It is used to exploit successes, to preserve freedom of action, and to reduce vulnerability. It continually poses new problems for the enemy by rendering their actions ineffective, eventually leading to defeat.
Unity of Command – For every objective, seek unity of command and unity of effort. At all levels, employment of military forces, in a manner that masses combat power toward a common objective, requires unity of command and unity of effort. Unity of command means all the forces are under one responsible commander. It requires a single commander with the requisite authority to direct all forces in pursuit of a unified purpose.
Simplicity – Prepare clear, uncomplicated plans and concise orders to ensure thorough understanding. Everything in war is very simple, but the simple thing is difficult. To the uninitiated, military operations are not difficult. Simplicity contributes to successful operations. Simple plans and clear, concise orders minimize misunderstanding and confusion. Other factors being equal, parsimony is to be preferred.
Surprise – Strike the enemy at a time or place or in a manner for which he is unprepared. Surprise can decisively shift the balance of combat power. By seeking surprise, forces can achieve success well out of proportion to the effort expended. Surprise can be in tempo, size of force, direction or location of main effort, and timing. Deception can aid the probability of achieving surprise.
How This Applies to Us
By now, you are likely thinking, Mark, we know your Marine background, but why and how does this apply to us? It applies because we are engaged is continual "warfare," of a sort, to position ourselves in a place of authority for all things neuromusculoskeletal. The thing about the Principles of War is that when we violate them, we lose. Regardless of where in the limits of chiropractic scope you practice, be it so-called "principled straight" or "medipractor," the principles apply to you.
Unfortunately, those who plan and fight the chiropractic battles violate these principles continuously. With the inevitable change in our health care delivery in the United States, we violate at our own peril. The following nine violations are just a hip shot at our subluxations that if not adjusted, will result in us reaching our limitations of matter sooner than later. This isn't about insurance acceptance. We all have to make enough money to meet essentials, e.g., food on the table, roof overhead, clothes on our backs, money to keep the doors open so we can keep delivering care, etc.
Violations of the Principles
Violation 1: Of the 70,000 licensed DCs, only 15,000 belong to a national association. At 21 percent, we certainly don't have Mass on our side. There is strength in numbers, but we don't have it … at least not yet.
Violation 2: We are always defending ourselves and on rare exception go on the Offensive. This isn't the NFL, where defense wins ballgames. We need to get out of a second-class mentality, stop letting others define us – and quit trying to define each other.
Violation 3: What is our Objective as a profession? Inclusion? Parity? Purity? Uniformity? Redefining ourselves as PCPs? All of the above?
Violation 4: Security? We probably are best at this, right? No one knows what anyone is doing. We are best secure from ourselves.
Violation 5: Economy of Force? At 20 percent involvement, we don't have any choice. This will always be a challenge, even with 100 percent involvement. Where do we concentrate our efforts and resources?
Violation 6: The favorite Maneuver of our profession is to circle the wagons and fire inward. We have all heard this cliché and seen it in action in New Mexico, Florida and other states.
Violation 7: Unity. A noted Marine general used to talk about people who are "victims of their own experience." He could be speaking about chiropractors. The face of health care has changed radically from the "Mercedes '80s." In light of the PPACA, would he have opposed one national organization to represent chiropractic? He would have found a way to unify us all.
Violation 8: Simplicity. I haven't seen anything simple and straightforward yet. Everything gets convoluted, whether it's dealing with the CCE, COSCA, NBCE, state boards, or some chiropractic haters.
Violation 9: What would be a real Surprise is if the AMA and APTA were to awaken one morning to 70,000 chiropractors aligned (pun intended), having gained the authority to offer the full scope of conservative health care services they have been trained to provide.
Time to Work Together
I hate it when people talk about "going to war" as an analogy for sport or really anything other than locating, closing with and destroying the enemy by fire and maneuver, or repelling their counterattack by fire and close combat. But make no mistake, we are engaged in a struggle for our identity, our cultural authority and our professional survival. And in this struggle, to succeed, we must not violate the Principles of War.
The Association of Chiropractic Colleges gave us "Chiropractic is a healthcare discipline that emphasizes the inherent recuperative power of the body to heal itself without the use of drugs or surgery."2 Aeschylus (525-456 BC) reminds us: "So in the Libyan fable it is told that once an eagle, stricken with a dart, said, when he saw the fashion of the shaft, 'With our own feathers, not by others' hands, are we now smitten.' And R.W. Stephenson3 shares with us Principle #6, The Principle of Time: "There is no process that does not require time. "
Let's work together to prevent Principle #24, The Limits of Adaptation, from being realized and ensure matter, as manifested in our profession, is not limited. Fellow chiropractors, the hour has struck for Principle #32, The Principle of Coordination, as it applies to the body chiropractic: "Coordination is the principle of harmonious action of all the parts of an organism, in fulfilling their offices and purposes." Or as the Marines would say: "Gung Ho."
Semper Fi.
References
When sports chiropractors first appeared at the Olympic Games in the 1980s, it was alongside individual athletes who had experienced the benefits of chiropractic care in their training and recovery processes at home. Fast forward to Paris 2024, where chiropractic care was available in the polyclinic for all athletes, and the attitude has now evolved to recognize that “every athlete deserves access to sports chiropractic."
It is estimated that 61% of patients with CTS avoid taking surgical options due to postoperative complications and costly surgical procedures. Chiropractic care offers a comprehensive and effective treatment for carpal tunnel syndrome, addressing the condition from multiple angles. Recent studies also have unveiled a game-changing adjunct to chiropractic treatments for CTS: nerve flossing.
Some doctors thrive in a personality-based clinic and have a loyal following no matter what services or equipment they offer, but for most chiropractic offices who are trying to grow and expand, new equipment purchases help us stay relevant and continue to service our client base in the best, most up-to-date manner possible. So, regarding equipment purchasing: should you lease, get a bank loan, or pay cash?
